Chapter 29: Disorders of the Bladder

• What is a role of lower urinary tract?

  Transport urine formed by the kidneys and allow removal from body
• In lower urinary tract the urine movement effect is due of?

  Gravity and facilitated by peristaltic movement of ureters
• What are the diagnostic test for lower urinary tract?(4)

  Urinalysis

  Ultrasonography

  Fluoroscopic voiding cystourethrigraphy

  Urodynamic testing
• What are the mechanics of micturition in lower urinary tract?(5)

  -Bladder innovation supplied by sympathetic nerves exit from spinal cord at L1 & L2

  -Simulation of parasympathetic nerves from S1 to S4

  -Somatic pudendal nerve innervates vessels

  -Micturition requires central, automatic, & peripheral nervous system functioning

  -Result of parasympathetic and voluntary motor control
• What might voiding dysfunction be secondary to? (3)

  -disorders of lower urinary tract

  -pathologies affecting central, autonomic, & peripheral nervous system

  -factors affecting control of micturition
• What are the 3 incontinence and voiding dysfunction?

  Urge, stress, mixed incontinence
• What is urge incontinence?


  maybe idiopathic due to bladder infection, radiation therapy, tumors/stones, or CNS damage
• What is stress and incontinence?


  weakening of pelvic muscles or intrinsic urethral sphincter deficiency
• What is mixed incontinence?

  Combination of stress and urge incontinence.
• A broad classification of voiding dysfunction and specific cause of pathology that produces a disruption of nervous communication governing micturition is what bladder?


  Neurogenic bladder
• What are the treatment options for voiding dysfunction? (3)


  Behavioral

  Pharmaceutical

  Surgical
• What is the 4th most common cancer in males and 8th most common and females?

  Bladder cancer
• Bladder cancer has an increase in risk with what?

  Age
• What are some predisposing factors in neoplasms? (2)

  Smoking

  Exposure to carcinogenic chemicals
• Where do most tumors originate from?

  Transitional epithelium lining the urinary tract
• Bladder cancer primarily manifest as? (2)

  Hematuria

  Frequency & urgency may be present
• What is used for diagnosis with tissue biopsy and washings?

  Cystoscopy
• What are the treatment protocols for neoplasms?

  Type

  Grade and stage of bladder cancer

  Surgery

  Radiation therapy

  Chemotherapy

  Immunotherapy